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Development of a trigger tool to identify adverse events and no-harm incidents in paediatric oncology: a modified

Charlotte Engvall1,2, Margaretha Stenmarker1,2,3,4, Ann-Christine Andersson5,6

  • 1Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Frontiers in Health Services
|January 28, 2026
PubMed

Insights

A new Paediatric Oncology Trigger Tool was developed to detect adverse events and no-harm incidents in children with cancer transitioning from hospital to home care. This tool enhances patient safety in paediatric oncology settings.

Area of Science:

  • Oncology
  • Patient Safety
  • Healthcare Management

Background:

  • Paediatric oncology care is shifting towards day care and home healthcare.
  • Existing trigger tools lack specificity for paediatric oncology's unique patient and professional collaborative care models.
  • There is a need for enhanced safety knowledge and tools in paediatric oncology.

Purpose of the Study:

  • To develop a Paediatric Oncology Trigger Tool.
  • To facilitate the detection of adverse events and no-harm incidents.
  • To improve patient safety in the transition from hospital to home care for paediatric oncology patients.

Main Methods:

  • A multi-step process including literature search and a modified Delphi process with experts from all Swedish paediatric oncology centres.
  • National multicentre study involving medical record review from four centres, covering 64% of the population.
  • Data collection via virtual meetings and web-based surveys using a four-point Likert scale to rate trigger relevance, comprehensibility, and usefulness.

Main Results:

  • Development of the Paediatric Oncology Trigger Tool.
  • The final tool comprises 22 triggers with definitions and decision support information.
  • The tool is designed to enhance understanding of patient safety in paediatric oncology.

Conclusions:

  • A context-specific trigger tool, the Paediatric Oncology Trigger Tool, was successfully developed through a systematic process.
  • The tool addresses unique patient safety needs in paediatric oncology.
  • It can be utilized in local safety initiatives to improve care for children with cancer.
Abstract

Keywords:
adverse eventsmodified Delphi processno-harm incidentspaediatric oncologypatient safetyretrospective record reviewtrigger tool

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